On August 12th, New York State Office of Mental Health (OMH) issued a guidance document regarding the Licensed Behavioral Health Practitioner (LBHP) benefit under the State’s Medicaid 1115 Waiver. The new guidance, effective October 1, 2016, authorizes Medicaid Managed Care Organizations (MMCOs), which include Mainstream Medicaid Managed Care Plans, Health and Recovery Plans, and HIV-Special Needs Plans, to reimburse OMH-licensed clinics for an array of mental health services provided off-site of their clinic or satellite locations at 150% of the Article 31 on-site rate. These reimbursements can cover both prospective services and retroactive services provided as of October 1, 2015 in New York City or July 1, 2016 in the rest of the State.
The cover letter and guidance document are attached.